Activity 8: Who needs palliative care?

Palliative care is provided to people, regardless of age, who have life-limiting illnesses. It's not dependent on a specific medical diagnosis, but on a person's needs. It may be beneficial for people with health needs and problems, including:

• cancer
• HIV/AIDS
• Motor Neurone Disease
• Muscular Dystrophy
• Cystic Fibrosis
• Multiple Sclerosis
• end-stage dementia
• end-stage respiratory disease
• end-stage cardiac disease
• end-stage liver disease
• end stage renal failure
• older people dying as a consequence of the ageing process
• degenerative conditions or significant deterioration related to ageing. [1] 

There are many factors determining the type of health service provided to people with life-limiting illnesses and their families.

Palliative Care Australia has defined three broad subgroups to illustrate the type of care people need.

The following diagram is a model of the level of need within the population of individuals with a life-limiting illness.

Remember! A key factor influencing the type of service to provide people with life-limiting illnesses is the intensity of their needs.
 
Primary care needs
Many people with life-limiting illnesses may have access to their own resources, or have the support of primary health care services that effectively meet their needs. These people may not require specialist palliative care services.

Intermediate needs
Other people may experience occasional problems, such as an exacerbated physical symptom or psychological need that requires more attention than the primary caregivers are able to provide. In these cases, what's needed is access to a specialist palliative care service for advice, while they continue being cared for by their primary health care professional.

Complex needs
There are people who have more complex physical, social, psychological and/or spiritual needs. These people may need specialist practitioners, who work in partnership with primary care providers to develop, implement and evaluate specific care plans. This group will typically benefit from being referred to a specialist palliative care service. [2]

Key concepts to consider

• All people with life-limiting illnesses have a right to health care that's appropriate to their needs.
• Not everyone with a life-limiting illness will require access to a specialist palliative care service. For many people, care needs can be met by community and personal resources and the support of primary health care services.
• As a health care professional, you are likely to come into contact with people in a variety of settings who may benefit from palliative support. All health care professionals, therefore, need knowledge and skills in providing palliative care.

Thinking points

REFERENCES

1. Commonwealth of Australia. (2000). National Palliative Care Strategy: A national framework for palliative care service development. Canberra: Commonwealth of Australia. Retrieved September 15, 2010, from http://www.quitnow.info.au/internet/main/publishing.nsf/Content/palliativecare-pubs-npcstrat.htm~palliativecare-pubs-npcstrat-3.htm

2. Palliative Care Australia. (2005). A guide to Palliative Care Service Development: A population based approach. Canberra: Palliative Care Australia. Retrieved September 15, 2010, from http://www.palliativecare.org.au/Portals/46/Factsheet%20-%20palliative%20care%20service%20development.pdf